Successful Treatment of Generalized Discoid Skin Lesions With AzathioprineIts Use in a Patient With Systemic Lupus Erythematosus

From the Arthritis and Rheumatism Branch, National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases (Drs Tsokos and Klippel), and the Dermatology Branch, National Cancer Institute (Dr Caughman), National Institutes of Health, Bethesda, Md.

• A 20-year-old patient had systemic lupus erythematosus and extensive generalized discoid disease that failed to respond to conventional treatment with topical steroids and high doses of hydroxychloroquine sulfate (Plaquenil). The skin lesions responded dramatically to 100 mg of azathioprine sodium daily, flared when the drug treatment was discontinued, and again responded on reinstatement of the same dosage of azathioprine. The case report suggests that extensive discoid skin lesions can be successfully treated with oral azathioprine.